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Schizophr Res. 2017 Jan;179:91-96. doi: 10.1016/j.schres.2016.09.036. Epub 2016 Oct 6.

A pilot study of cognitive insight and structural covariance in first-episode psychosis.

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Department of Neuroscience, University of Calgary, Alberta, Canada.
Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada. Electronic address:
Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada.
McGill Centre for Integrative Neuroscience, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Qu├ębec, Canada.
Department of Psychiatry, University of Calgary, Alberta, Canada; Strategic Clinical Network for Addictions and Mental Health, Alberta, Canada; Department of Pediatrics, University of Calgary, Alberta, Canada.
Department of Radiology and Paediatrics, University of Calgary, Alberta, Canada; Child and Adolescent Imaging Research (CAIR) Program, Alberta Children's Hospital Research Institute, Alberta, Canada.


Cognitive insight is described as a balance between one's self-reflectiveness (recognition and correction of dysfunctional reasoning), and self-certainty (overconfidence). Neuroimaging studies have linked the ventrolateral prefrontal cortex (VLPFC) to cognitive insight in people with psychosis. However, the relationship between cognitive insight and structural connectivity between the VLPFC and other brain areas is unknown. Here, we investigated the modulation of cognitive insight on structural covariance networks involving the VLPFC in a first-episode psychosis sample. Fifteen patients with a first-episode psychosis provided magnetic resonance (MR) scans and completed the Beck Cognitive Insight Scale (BCIS). MR scans were also available for 15 historical controls. Seed-based analysis of structural covariance was conducted using the Mapping Anatomical Correlations Across the Cerebral Cortex (MACACC) methodology, whereby Pearson correlation coefficients were extracted between seed regions in left and right VLPFC and cortical thickness across the brain. Structural covariance maps between groups were compared at each vertex. In first-episode subjects, we evaluated the modulation of BCIS scores on cortical covariance between VLPFC and every other vertex. Findings showed no significant group difference between first-episode psychosis subjects and controls in thickness covariance seeded from left or right VLPFC. However, in first-episode psychosis subjects, a positive association with self-certainty was found in networks seeded from both left and right VLPFC with thickness in medial frontal cortex and right pars triangularis. No significant associations were found for self-reflectiveness. These results suggest that self-certainty, but not self-reflectiveness, positively modulated cortical covariance in a frontal network in patients with a first-episode psychosis.


Cognitive insight; Cortical covariance; Cortical thickness; First-episode schizophrenia; Magnetic resonance imaging; Ventrolateral prefrontal cortex

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